Session Time: 3:00pm-4:00pm
Disclosures: Michael D. Guthrie, MD: No financial relationships or conflicts of interest
Objective: To characterize associations of sleep-related symptoms to clinical outcomes following sports related concussion (SRC).
Design: Retrospective chart review Setting : Outpatient Concussion Specialty Clinic in Pittsburgh, Pennsylvania Participants : 162 athletes aged 12-22 with a SRC per consensus guidelines were seen at their initial clinic visit from August 2016 to March 2018
Interventions: Patients self-reported medical history and completed vestibular-ocular screening and computer-based cognitive testing. Exclusion criteria included moderate-severe TBI or premorbid neurological or vestibular disorders. Individuals were grouped into high and low sleep symptom groups based on total sleep-related item scores on the Post-concussion Symptom Scale (PCSS).
Main Outcome Measures: Sleep history, PCSS (22 items scored on a 7-point Likert scale from 0 – 6), Immediate Post-concussion Assessment and Testing (ImPACT), Vestibular Ocular Motor Screening (VOMS), and recovery time in days
Results: 78 individuals scored 5 or less on the sum of the 5 sleep-related PCSS items compared to 84 who scored 6 or higher. There were more females than males in the high sleep symptom group (65% vs 47%, p=0.024). T-tests revealed significantly worse PCSS non-sleep related scores (33.2±16.8 vs 13.8±9.6), visual memory (64.4±14.6 vs 69.6±14.0, p=0.024) and processing speed (31.3±7.2 vs 34.3±7.8, p = 0.015) in the high sleep symptom group. Chi-squared tests revealed those in the high sleep symptom group were more likely to score above clinical cutoffs for smooth pursuits (OR=2.22, 95% CI:1.01 – 4.88) and horizontal saccades (OR=2.28, 95% CI: 1.02 – 5.11). There was no statistical difference in average recovery times (64.9±64.1 vs 48.5±44.3, p=0.062). Conclusions: The findings suggest that patients with more severe post-concussion sleep disruption have worse clinical outcomes at initial visit following SRC. Clinicians should assess sleep history and post-concussion sleep symptoms in their patients following SRC to help inform earlier intervention for sleep dysfunction that might enhance recovery.
Level of Evidence: Level II
To cite this abstract in AMA style:Guthrie MD, Kontos A, Eagle S. Sleep Symptom Associations with Clinical Outcomes in Concussion [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/sleep-symptom-associations-with-clinical-outcomes-in-concussion/. Accessed September 28, 2023.
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